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The following is an alphabetical listing of common signs and symptoms of arthropod-borne diseases. Unfortunately, few signs and symptoms are specific to any one disease. Further differentiation by appropriate laboratory or radiologic tests may be needed. By no means should this listing be considered as a complete differential diagnosis of any of the symptoms discussed.
Adenopathy: Generalized adenopathy may occur in the early stages of African trypanosomiasis – the glands of the posterior cervical triangle being most conspicuously affected (Winterbottom’s sign). Adenopathy may also be seen in the acute stage of Chagas’ disease.
Anemia: Anemia may be seen in cases of malaria, babesiosis, and trypanosomiasis. Anemia can be especially severe in fal-ciparum malaria.
Blister: A blister may occur at arthropod bite sites. Blistering may also occur as a result from blister beetles contacting human skin.
Bulls-Eye Rash (see Erythema Migrans)
Chagoma: An indurated, erythematous lesion may occur on the body – often head or neck – caused by Trypanosoma cruzi infection (Chagas’disease). A chagoma may persist for 2–3 mo.
Chyluria: The presence of chyle (lymphatic fluid) in the urine is often seen in lymphatic filariasis. Urine may be milky white and even contain microfilariae.
Coma: Sudden coma in a person returning from a malarious area may indicate cerebral malaria. African trypanosomiasis (sleeping sickness) may also lead to coma after a long period of increasingly severe symptoms of meningoen-cephalitis. Rocky Mountain Spotted Fever and other rickettsial infections may also lead to coma.
Appendix 1Signs and Symptoms of Arthropod-Borne Diseases
227
228 Appendix 1
Conjunctivitis: Chagas’ disease and onchocerciasis may lead to chronic conjunctivitis.
Dermatitis: Several arthropods may directly or indirectly cause dermatitis. Chiggers and other mites may attack the skin, causing a maculopapular rash. Scabies mites may burrow under the skin’s surface making itchy trails or papules. Lice may give rise to hypersensitivity reactions with itchy papules. Chigoe fleas burrow in the skin (especially on the feet), causing local irritation and itching. Macules or erythematous nodules may result as a secondary cutane-ous manifestation of leishmaniasis.
Diarrhea: Leishmaniasis (and specifically visceral leishmaniasis – kala-azar) may lead to mucosal ulceration and diarrhea. In falciparum malaria, plugging of mucosal capillaries with parasitized red blood cells may lead to watery diarrhea.
Edema: Edema may result from arthropod bites or stings. Loiasis (a nematode worm transmitted by deer flies) may also cause edema – a unilateral circumorbital edema as the adult worm passes across the eyeball or lid. Passage of the worm is brief, but inflammatory changes in the eye may last for days. Loiasis may also lead to temporary appearance of large swellings on the limbs, known as Calabar swellings at the sites where migrating adult worms occur. Unilateral edema of the eyelid, called Romaña’s sign, may occur in Chagas’ disease. African trypanosomiasis (sleeping sickness) may result in edema of the hips, legs, hands and face.
Elephantiasis: Hypertrophy and thickening of tissues, leading to an “elephant leg” appearance, may result from lymphatic filariasis. Various tissues may be affected, including limbs, the scrotum, and the vulva.
Eosinophilia: Helminth worms may cause eosinophilia. Atopic dis-eases, such as rhinitis, asthma, and hay fever also are characterized by eosinophilia.
Eosinophilic CerebrospinalFluid Pleocytosis:
Cerebrospinal fluid eosinophilic pleocytosis can be caused by a number of infectious diseases (including rickettsial and viral infections), but is primarily associ-ated with parasitic infections.
Epididymitis: Epididymitis, with orchitis, may be an early complication of lymphatic filariasis.
Appendix 1 229
Erythema Migrans: Erythema migrans may follow bites of ticks infected with the causative agent of Lyme disease, Borrelia burgdor-feri. Typically the lesion consists of an annular erythema with a central clearing surrounded by a red migrating border. Although erythema migrans does not always occur, it is virtually pathognomonic for Lyme disease.
Eschar: A round (generally 5–15 mm) spot of necrosis may result from boutonneuse fevers, American boutonneuse fever, (spotted fever group illnesses), or scrub typhus. An eschar develops at the site of tick or chigger bite.
Excoriation: Lesions produced by “self-scratching” may be a sign of imaginary insect or mite infestations (delusions of parasitosis).
Fever: Fever is a common sign of many arthropod-borne dis-eases, including the rickettsioses, thyphus, dengue, yel-low fever, plague, the encephalitides, and others. In some cases, there are cyclical peaks of fever, such as in relaps-ing fever (tick-borne) or malaria. Falciparum malaria is notorious for causing extremely high fever (107°F or higher). Filariasis may be marked by fever, especially early in the course of infection.
Hematemesis: Coffee-ground color or black vomit may be a sign of yel-low fever.
Hemoglobinuria: Falciparum malaria can cause “blackwater fever.”Hydrocele: Hydrocele may result from lymphatic filariasis, develop-
ing as a sequel to repeated attacks of orchitis.
Kerititis: Inflammation of the cornea is sometimes a result of ocu-lar migration of Onchocerca volvulus microfilariae. It may lead to blindness.
Leukopenia: Leukopenia is a prominent finding in cases of ehrlichio-sis. It may also occur (3,000–6,000/mm3) with a relative monocytosis during the afebrile periods of malaria.
Lymphadenitis: Inflammation of one or more lymph nodes may be a sign of lymphatic filariasis – especially involving the femoral, inguinal, axillary, or epitrochlear nodes.
Lymphangitis: Lymphangitis can be an early symptom of lymphatic filariasis, involving the limbs, breast, or scrotum.
Lymphocytosis: Lymphocytosis may occur in Chagas’ disease.Maggots: The presence of fly larvae in human tissues is termed
myiasis. Various blow flies, bot flies, and other muscoid flies are usually involved.
230 Appendix 1
Meningoencephalitis: Meningoencephalitis has many causes, but may be a result of trypanosomes in the case of African trypano-somiasis (sleeping sickness) or Chagas’ disease (although generally milder). Falciparum malaria infection may be cerebral, with increasing headache and drowsiness over several days, or even sudden onset of coma.
Myocarditis: Chagas’ disease may lead to myocardial infection. African trypanosomiasis may also cause myocarditis to a lesser extent.
Neuritis: Neuritis may be caused by bee, ant, or wasp venom. Occasionally stings to an extremity result in weakness, numbness, tingling, and prickling sensations for days or weeks. Neuritis may also result from infection with the Lyme disease spirochete.
Nodules, Subcutaneous:
Onchocerciasis may present as skin nodules (see Onchocercoma). Tick bites may also result in nodules. Fly larvae in the skin (myiasis) may also present as nod-ules. Common species involved are the human botfly larva, Dermatobia hominis, the Tumbu fly, Cordylobia anthropophaga, and rodent botfly larvae, Cuterebra spp.
Onchocercoma: Coiled masses of adult O. volvulus worms beneath the skin enclosed by fibrous tissues may occur in patients living in tropical countries endemic for ochocerciasis.
Orchitis: Orchitis may be a symptom of lymphatic filariasis; repeated attacks may lead to hydrocele.
Paralysis: Ascending flaccid paralysis may result from tick attach-ment. The paralysis is believed to be caused by a salivary toxin injected as the tick feeds.
Proteinuria: Proteinuria, with hyaline and granular casts in the urine, often occurs in falciparum malaria.
Puncta: A small, point-like pierce mark may mark the bite or sting site of an arthropod. Paired puncta may indicate spider bite or centipede bite.
Rash: There are myriad causes of rash, but rash may accompany many arthropod-borne diseases, such as Rocky Mountain Spotted Fever, ehrlichiosis, murine typhus, and African trypanosomiasis. The rash may appear to be ring-like, and expanding in the case of Lyme disease (see Erythema Migrans). An allergic urticarial rash may be seen in the case of bites or stings.
Appendix 1 231
Romaña’s Sign: A common sign early in the course of Chagas’ disease, Romaña’s sign is a unilateral palpebral edema, involving both the upper and lower eyelids. This generally occurs when a kissing bug (the vector of the Chagas’ organism) bites near the eye.
Shock: Shock may occur from arthropod stings (rarely bites) as a result of hypersensitivity reactions to venom or saliva. Shock may also accompany falciparum malaria.
Splenomegaly: Splenomegaly can be a result of lymphoid hyperplasia in both African and American trypanosomiasis. It may also occur in visceral leishmaniasis (kala-azar).
Tachycardia: Both African and American trypanosomiasis may pro-duce tachycardia. In Chagas’ disease tachycardia may persist into the chronic stage where it may be associated with heart block.
Ulcers, Cutaneous: A shallow ulcer (slow to heal) may be a sign of cutaneous leishmaniasis. In the New World, lesions from cutaneous leishmaniasis are most often found on the ear. Also, a firm, tender, raised lesion up to 2 cm or more in diameter may occur at the site of infection in African trypanosomiasis.
Urticaria: Urticaria may result from an allergic or generalized sys-temic reaction to arthropod venom or (more rarely) saliva.
Verruga Peruana: A benign dermal eruption (peruvian warts) is one mani-festation of bartonellosis. The verrugae are chronic, last-ing from several months to years, and contain large numbers of Bartonella bacilliformis bacteria.
Winterbottom’s Sign: In the early stages of African trypanosomiasis, patients may exhibit posterior cervical lymphadenitis.
A.2.1 Agglutination
Agglutinations are antibodies that cause clumping together (agglutination) of microorganisms, erythrocytes, and often antigenic particulates. If the serum being tested is specific, agglutinins present will cause cultured parasites or bacteria to clump when the serum is introduced.
A.2.2 Complement Fixation
In CF tests, the suspected serum is incubated with a known source of antigen, permitting the antigen-antibody interaction to bind complement and remove it from the reaction mixture. A sheep-blood indicator is then added which hemolyzes in the presence of free complement. If the sheep cells fail to hemolyze, complement is absent; its absence testifies to the prior occurrence of an antigen-antibody reaction. By varying the serum or antigen dilution, one can achieve a crude approximation of titer.
A.2.3 Direct Fluorescent Antibody
A DFA test (some texts refer to it as direct immunofluorescence or DIF) utilizes fluorescent tagging of antibodies produced against the pathogen in question. These tagged antibodies can be purchased commercially against a wide variety of organ-isms. When tagged antibodies are placed on a microscope slide containing the pathogen, the organisms fluoresce when viewed by fluorescent microscopy. DFA is a one-step procedure involving the placement of tagged antibody on a suspect smear of tissue or blood and viewing (after a brief phosphate-buffered saline [PBS] wash) with a UV light-equipped microscope.
Appendix 2Diagnostic Tests Used in Arthropod-Borne Diseases
233
234 Appendix 2
A.2.4 Enzyme-Linked Immunosorbent Assay (ELISA)
Similar, if not identical, to a test called Enzyme Immunoassay (EIA), the ELISA test may be used for quantitative determination of either antigen or antibody. The appropriate antigen or antibody is bound to (usually) plastic microtiter plates, and the specimen to be tested is then added and given time to react with the already present antigen or antibody. After a wash to remove any unbound test material, an enzyme-linked antigen or antibody is added. After a second wash, a substrate is added that will react with the remaining enzyme to produce a color change.
A.2.5 Hemagglutination Inhibition (HI)
The HI test measures the presence of hemagglutination-inhibiting antibody toward a particular organism. The suspected serum is incubated with fluid medium known to be capable of agglutinating red cells. After the incubation period, the agglutinat-ing potency is measured, and the absence of subsequent agglutination indicates the presence of specific antibodies in the serum.
A.2.6 Immunohistochemistry (IHC)
IHC is used to visualize pathogens in tissues as well as to diagnose abnormal cells such as those found in cancerous tumors. The test is performed on tissue sections and, in most cases, utilizes an antibody conjugated to an enzyme, such as peroxi-dase, that can catalyse a color-producing reaction. Alternatively, the antibody can be tagged to a fluorescent chemical such as FITC, rhodamine, or Texas Red, for reading with a fluorescent microscope.
A.2.7 Indirect Fluorescent Antibody (IFA)
The IFA test is a two-step test involving the placement of patient serum suspected of containing antibodies on a slide with fixed, known antigen. After an incubation period and PBS washing, the slide is then covered with a solution containing fluorescent-tagged antihuman antibodies. After a second incubation period and PBS washing, the slide is viewed by fluorescent microscopy. Fluorescence of antigen on the slide is considered evidence of patient antibodies toward that par-ticular organism. By serially diluting patient serum, a titer can be determined.
Appendix 2 235
A.2.8 Leishmanin (Montenegro Test)
The leishmanin test (not available in the United States) is sometimes used to help diag-nose cases of cutaneous and muco-cutaneous leishmaniasis. It involves an intradermal injection of a suspension of killed promastigotes. A high percentage of Leishmania tropica and Leishmania braziliensis infections will test positive by this test.
A.2.9 Mazzotti
The Mazzotti test is used to determine if a patient has onchocerciasis. It can be dangerous and is not used in many areas. It consists of oral administration of 25 or 50 mg of diethylcarbamazine to a patient suspected of having onchocerciasis. If the patient is infected, an intense itching occurs in a few hours (as the microfilariae die within the skin). The itching is then controlled by short-term administration of corticosteroids, or will subside on its own within 2–3 d.
A.2.10 Neutralization
The neutralization test (NT) is the most specific immunologic test for the majority of viral infections. The identification of an unknown viral isolate is made by ana-lyzing the degree to which antisera of known reactivity prevent the virus from infecting tissue-culture cells, eggs, or animals. If neutralizing antibody is present, virus cannot attach to cells, and infectivity is blocked
A.2.11 Polymerase Chain Reaction (PCR)
PCR has dramatically changed diagnostic microbiology in recent years. PCR makes specific identification of pathogens possible, even when only a few organ-isms are present. PCR is a highly sensitive technique by which minute quantities of DNA or RNA sequences are enzymatically amplified to the extent that a sufficient quantity of material is available to reach a threshold signal for detection using a specific probe. The scientific basis of PCR is that each infectious disease agent (in fact, every living thing) possesses a unique signature sequence in its DNA or RNA by which it can be identified. In other words, there is a unique sequence of amino acids for each organism. By finding those unique sequences and constructing prim-ers to amplify those specific areas of DNA, identification of an organism can be accomplished from a blood or tissue sample, or even from an infected arthropod
236 Appendix 2
vector. PCR is carried out using a thermocycler, which produces a series of heat-cool cycles, whereby double-stranded DNA is dissociated into single strands that are in turn allowed to anneal in the presence of specific primers on cooling. Through the successive heat–cool cycles (usually about 30), the DNA sequence to be detected is amplified millions of times. The product is then visualized after sepa-ration on agarose gels by electrophoresis and appropriate staining. There are vari-ous types of PCR, such as real-time PCR which allows more samples to be processed at once, and nested PCR which is more sensitive than either real-time or direct PCR.
Index
AAccidental myiasis, 209
contributing factors, 215treatment, 217–218
Artemisinin-based combination therapy (ACT), 44–45
Adenopathy, 227Aedes aegypti, 21, 58–61, 63
biting patterns, 58breeding, 61dengue virus, 58geographic distribution, 61illustration, 60and YF, 63
Aedes africanus, 21, 67and YF, 67
Aedes albopictus, 21, 57–61biting patterns, 58dengue virus, 58geographic distribution, 61
Aedes mosquitoes, 21, 32–35, 57–61, 67breathing, 31–33dog heartworm, 74egg laying, 34positions, 33
Aedes vexans, 33African sleeping sickness, 160–164
causative agent, 160clinical and laboratory findings, 161diagnosis, 160–161ecology, 161–162geographical distribution, 161medical significance, 160prevention and control, 163symptoms, 160treatment, 163vectors, 162
African tick bite fever (ATBF), 96African trypanosomiasis, 13, 160–164
Agglutination, 141, 233African sleeping sickness
diagnosis, 161Allergy to stings, 13Allopurinol, 159Amastigote, 148Amblyomma, 85, 93–100, 107Amblyomma americanum, 85, 93–100, 107
geographical distribution, 100illustration, 99tularemia, 107
Amblyomma hebraeum, 85, 94Amblyomma maculatum, 85, 90–94
and American boutonneuse fever, 85, 90–94
American dog tick, 85, 87–88American trypanosomiasis, 153–159Amodiaquine, 45Amoxicillin, 105
LD treatment, 105Amphotericin B
leishmaniasis treatment, 149Anaplasma marginale, 96Anaplasma phagocytophilum, 96–98Anaplasmosis (HGA), 96–98Anemia, 38, 227Anopheles darlingi, 40
geographic distribution, 42illustration, 42malaria, 40
Anopheles freeborni, 26catholic feeder, 26malaria vectors, 26, 40
Anopheles gambiae, 40geographic distribution, 41illustration, 41malaria, 40
Anopheles hermsi, 26, 40malaria vectors, 40
237
238 Index
Anopheles leucosphyrus, 40, 43geographic distribution, 43illustration, 43malaria, 40
Anopheles maculipennis, 27Anopheles mosquitoes, 21, 26–27, 31–45,
72, 74Bancroftian filariasis, 72breathing, 31breeding, 33cyclopropagative transmission, 22dog heartworm, 74egg laying, 33positions feeding, 32vector control, 44vectors, 21, 40–43
Anopheles punctipennis, 26malaria vectors, 40
Anopheles quadrimaculatus, 27, 40malaria vectors, 40
Anophelinae, 31Antibody-dependent
Enhancement (ADE), 63Antimalarial drugs, 45Antiparasitic drug
onchocerciasis treatment, 166Ants
fire ants, 195–198sting apparatus, 202stings, 195–198
Arachnids, 4–9characteristics, 4
Arborival encephalitis, 49–57Argasidae, 81–84
illustration, 82Arkansas strain
HME, 98Arthropod-borne diseases
diagnostic tests, 233–236dynamics, 19–27signs and symptoms, 227–231
Arthropodscharacteristics, 3and health, 10–17, 19–27historical medical aspects, 10and HIV, 183–184human diseases transmitted, 19–27medical importance, 10–17,
19–27class list, 4stings and bites, 201–208
Asian tiger mosquitoes, 21, 57–61dengue virus, 58
AzithromycinLD treatment, 105
BBabesia bigemina, 110Babesia canis, 110Babesia divergens, 109Babesia equi, 110Babesia gibsoni, 110Babesia microti, 109–111
life cycle, 110Babesiosis, 109–111Bacillus thuringiensis, 166Bacon therapy, 218Bacterium tularense, 105
See also Francisella tularensisBancroftian filariasis, 68–74
biological transmission, 22geographic distribution, 69Wuchereria bancrofti, 70
Bartonella bacilliformis, 150Bartonella henselae, 140Bartonella quintana, 171Bartonellosis, 140, 150Bees, 13, 202
sting apparatus, 202stings, 204–206
Beetles, 16blister, 12larvae, 16
Benznidazole, 159Chagas’ disease treatment, 159
Biological transmissionclassification types, 20disease agents, 21
example, 22Bird-biting mosquitoes, 47, 50Bite lesions, 11, 201Bites, 11, 201
arthropods, 11, 201spiders, 5, 189, 201tick
illustration, 91Rocky Mountain Spotted Fever
(RMSF), 87Bite site
erythema migrans (EM), 101Biting flies
tularemia, 106Black death, 134Black flies, 165–166
filarial worms, 164Black rat, 134Black soldier fly, 209
illustration, 210Black widow spider, 11
venom, 11Blister, 12
Index 239
Blister beetles, 12Blow flies see Calliphoridae, 211–216
illustration, 213larvae, 213
Body lice, 170–171medical importance, 170
Boils (caused by fly larvae), 216–217
Borrelia burgdorferi, 104–105detection, 104
Borrelia hermsi, 116illustration, 115
Borrelia recurrentis, 116, 174Borrelia turicata, 116Bot fly, 212, 214Boutonneuse fever, 94Brown recluse, 187Brown widow spider
venom, 11bite effects, 11
Brugia malayi, 72, 74lymphatic filariasis treatment, 74
Brugian filariasis, 68geographic distribution, 69
Bubonic plague, 134–135Bulls-eye rash, 101Burrowing fleas, 10
CCalliphoridae, 211, 213Calliphora vicina, 211Campestral plague, 133Canine ehrlichiosis, 97Cantharidin, 12Carios rudis, 117Carrion’s disease, 150Cat fleas, 139, 141Catholic feeder
Anopheles freeborni, 26Cat-scratch disease (CSD), 140
clinical presentation, 139symptoms, 140transmission modes, 141treatment, 141
Cebidae monkeysand YF, 67
CefuroximeLD treatment, 105
Centipedes, 4, 9characterizations, 9
Central European TBE, 111Cercopithecidae monkeys
and YF, 67Cerebral malaria, 38
Chagas’ disease, 153–160clinical and laboratory findings,
153–154diagnosis, 157ecology, 157geographic distribution, 155medical significance, 153prevention and control,
159–160symptoms, 153–156transmission mode, 157treatment, 159vectors, 159
Chagoma, 227Cheese skipper, 210
illustration, 210Chiclero’s ulcer, 146Chikungunya, 56–57
outbreaks, 57symptoms, 56vectors, 57
Chigger-borne rickettsiosis, 166Chiggers, 166–169
life cycle, 169Chigoe fleas, 10Chilopoda
characteristics, 4, 9Chloramphenicol
louse-borne disease treatment, 174murine typhus treatment, 139RMSF treatment, 90scrub typhus treatment, 169tularemia treatment, 108
Chloroquineantimalarial drug, 40
Chrysomya albicepsillustration, 214
Chrysomya chloropygaillustration, 214
Chrysomya fliesillustration, 214
Chrysomya megacephalusillustration, 214
Chrysomya rufifacies, 211Chrysops discalis, 108Chyluria, 227Ciprofloxacin
CSD treatment, 141Clindamycin
human babesiosis treatment, 111Cochliomyia macellaria, 211
illustration, 213Cockroaches
mechanical transmission, 19transmission mode, 20
240 Index
Colorado tick fever (CTF), 113diagnosis and treatment, 113symptoms, 113
Coma, 38, 46, 50, 86, 112, 160, 227Commensal rats, 134Competent vectors, 12, 24–25Complement fixation, 138,
157, 233Conenose bugs, 157. See also Kissing bugs
and TriatomaConjunctivitis, 228Coquillettidia perturbans
mosquito vector, 48Cotton rats, 138Cowdria ruminantium 96CSD (cat-scratch disease),
139–141Ctenocephalides felis, 139, 141Culex mosquitoes, 21, 33–35, 46, 74
breathing, 33breeding, 35dog heartworm, 74egg laying, 35positions, 32SLE, 46, 50–52
Culex nigripalpusSLE mosquito vector, 51
Culex pipiensSLE mosquito vector, 51
Culex quinquefasciatusBancroftian filariasis, 70–71SLE mosquito vector, 51WNV mosquito vector, 54
Culex tarsalisillustration, 52SLE mosquito vector, 51WEE, 54WNV, 54
Culex tritaeniorhynchusJE, 56
Culicidae mosquitoes, 31subfamilies, 31
Culicinaecharacteristics, 31
Culiseta melanuraenzootic vector, 21, 47
Cutaneous leishmaniasis, 143–144
geographic distribution, 145Cuterebra flies, 215Cyclodevelopmental transmission
disease agents, 22Cyclopropagative transmission
disease agents, 22
DDaddy longlegs, 6Dark rice field mosquitoes, 33Deer fly, 21, 105, 108
illustration, 106Deer fly fever, 106Deer mice, 133, 135Deer tick, 101–102
geographic distribution, 101illustration, 101
DEET, 48, 89, 150leishmaniasis protection, 150
Delusions of parasitosis (DOP), 221Den 1
dengue virus serotype, 58Den 2
dengue virus serotype, 58Den 3
dengue virus serotype, 58Den 4
dengue virus serotype, 58Dengue, 58–63Dengue fever, 58–63Dengue hemorrhagic fever (DHF), 61–63
risk factors, 62Dengue shock syndrome (DSS), 61–62
risk factors, 62Dengue vaccine, 63Dengue virus, 58–63
geographic distribution, 59laboratory characteristics, 61mosquito markings, 60serotypes, 58spread, 58symptoms, 58treatment, prevention and control,
62–63Dermacentor andersoni
and CTF, 113geographic distribution, 88illustration, 87interference phenomenon, 25tick vectors, 21, 87, 107, 113
tick paralysis, 120–121Dermacentor marginatus, 96Dermacentor nuttalli, 96, 107Dermacentor silvarum, 96Dermacentor ticks
tick paralysis, 120–121Dermacentor variabilis, 21, 85, 87, 99
geographic distribution, 87illustration, 88tick paralysis, 120–121tick vectors, 87, 99, 107
Index 241
Dermatitis, 15, 101, 103, 165, 191, 223, 228Diagnostic tests
arthropod-borne diseases, 233Diarrhea, 228Diethylcarbamazine (DEC)
lymphatic filariasis treatment, 74onchocerciasis treatment, 166
Diplopoda, 4, 9characteristics, 9
Dip-Sticksmalaria diagnosis, 38scrub typhus diagnosis, 167
Direct fluorescent antibody, 233Dirofilaria immitis, 74Dirofilaria repens, 74Dirofilariasis, 74Dirofilaria tenuis, 74Dirofilaria ursi, 74Disease agents
biological transmission, 20mechanical transmission, 19
Diseasestransmitted by arthropods, 21
Disease transmissiondirect effects, 11indirect effects, 12
Dog antiparalysis serumtick paralysis treatment, 123
Dog heartworm, 74Dog tapeworm
transmission mode, 20Dog tick, 85, 87, 99Domestic rats, 134DOP, 221Doxycyline
ABF treatment, 94CSD treatment, 141ehrlichiosis treatment, 100LD treatment, 105murine typhus treatment, 139RMSF treatment, 90scrub typhus treatment, 169TBRF treatment, 117
Dust mites, 14
EEastern equine encephalitis (EEE), 46–49
control, 48differential diagnosis, 48ecology, 47geographic distribution, 47life cycle, 48onset of symptoms, 46
East Side agent, 25Edema, 228Ehrlichia, 96–100Ehrlichia canis, 97Ehrlichia chaffeensis, 97–98Ehrlichia ewingii, 98–100Ehrlichia phagocytophila, see Anaplasma
phagocytophilum, 98–100Ehrlichia ruminantium, 96Ehrlichiosis, 96–100EIA. See ELISA, 234Ekbom’s Syndrome, 221Elephantiasis, 68ELISA. See Enzyme-linked immunosorbent
assay, 234Encephalitides group, 46–56Encephalitis viruses
mosquito-transmitted, 46–56Envenomation, 11, 201Envenomization, 11, 201Enzootic cycle, 47Enzootic vector
Culiseta melanura, 47Enzyme immunoassay (EIA),
see ELISA, 234in scrub typhus diagnosis, 167
Enzyme-linked immunosorbent assay (ELISA), 234
African sleeping sickness diagnosis, 161Borrelia burgdorferi detection, 104Chagas’ disease diagnosis, 157leishmaniasis diagnosis, 147microfilariae identification, 70plague diagnosis, 136tick-borne encephalitis diagnosis, 113
Eosinophilia, 228Eosinophilic cerebrospinal fluid pleocytosis,
228Epidemic typhus, 21, 170–171Epididymitis, 228Epizootic cycle, 22, 47, 97Epizootic hosts
fleas, 135Eristalis tenax, 210
illustration, 211Erythema migrans,
bite site, 103Erythromycin,
CSD treatment, 141Eschar, 92–94
tick bite, 93–94Excoriation, 222Extrinsic factors
vector competence, 24
242 Index
FFacultative myiasis, 211
contributing factors, 215treatment, 217–218
Falciparum malaria, 38, 46, 50, 53, 56, 86, 96, 97, 100, 106, 112, 114, 229
Febrile anemia, 150Fever, 38Fiddle back spider, venom of, 11Field’s stain
microfilariae identification, 70Filarial worms, 22
biological transmission, 22life cycle, 73
Fire ants, 195–198attacks, 198venom, 196
Flea-borne diseases, 138–140Fleas, 131
biology, 131burrowing, 10cat, 139, 141chigoe, 10epizootic hosts, 135labeled diagram structure, 132larvae, 131mouthparts, 132Oriental rat flea, 135–138
illustration, 136transmission mode, 135
Flesh flies, 211illustration, 213
Fliesbiting
tularemia, 106black flies, 164–166
filarial worms, 164black soldier fly, 210blow flies, 210–211
illustration, 213larvae, 213
bot fly, 212Chrysomya
illustration, 214Cuterebra, 215deer fly, 21, 106, 108
illustration, 106flesh flies, 215
illustration, 213house flies
disease transmission, 20life cycle, 19–20
hump-backed, 212larvae, 212
mechanical transmission, 19–20, 179, 183–184
Megaselia, 211Musca, 211Muscina, 211Sarcophaga, 211
illustration, 213sand, 21, 143–151
biology, 143sand fly fever, 150Sarcophaga, 211screwworm, 212
illustration, 214Simulium, 21, 164–165soldier fly, 210
illustration, 210tsetse, 21, 160–165
illustration, 160tularemia, 21, 106, 108
Fomite houseand YF, 66
Francisella tularensis, 105
GGamma-interferon
leishmaniasis treatment, 149Gentamicin
CSD treatment, 141tularemia treatment, 109
Geographic distributionAedes aegypti, 61Aedes albopictus, 61African sleeping sickness, 161Amblyomma americanum, 100Anopheles darlingi, 42Anopheles gambiae, 41Anopheles leucosphyrus, 43Brugian filariasis, 70Chagas’ disease, 155deer tick, 101dengue virus, 59Dermacentor andersoni, 88Dermacentor variabilis, 88eastern equine encephalitis (EEE), 47HGE/HGA, 97Ixodes holocylus, 122Ixodes scapularis, 101Japanese encephalitis (JE), 57LaCrosse encephalitis (LAC), 56LBRF, 173leishmaniasis, 145lone star tick (LST), 100louse-borne typhus, 172
Index 243
malaria, 37Ornithodoros ticks, 118plague, 133scrub typhus, 167St. Louis encephalitis, 51tick-borne relapsing fever (TBRF), 118western equine encephalitis (WEE), 55yellow fever (YF), 64
Giant centipede, 9Giemsa stain
babesiosis diagnosis, 110leishmaniasis diagnosis, 148microfilariae identification, 70
Giemsa Wayson stainplague diagnosis, 136
Glossina, 161–164Glossina fuscipes, 162Glossina morsitans, 162Glossina pallidipes, 162Glossina palpalis, 162Glossina swynnertoni, 162Glossina tachinoides, 162Glucantime
leishmaniasis treatment, 149Grasshoppers, 3Gulf coast tick, 85, 90–94
HHaemagogus mosquitoes
sylvatic cycle, 67Haemaphysalis
tick vectors, 21, 96Haemaphysalis concinna, 96Haemaphysalis flava, 85
tick vectors, 85Hard ticks, 81–82
characteristics, 81Harvestmen, 6HE, 98HME, 97–98Head lice
life cycle, 5Health
arthropods direct effects, 11arthropods indirect effects, 12
Hemagglutination inhibition (HI), 234Hematemesis, 229Hemipteran insects, 153Hemoglobinuria, 229Hemolymph test, 25Hemolytic anemia, 38, 187Hermetia illucens, 210
illustration, 210
Hetrazanlymphatic filariasis treatment, 74
HGA/HGE. See also Human granulocytic ehrlichiosis (HE), 96–98
HIV transmissionand mosquitoes, 183–184
HME. See Human monocytic ehrlichiosis (HME), 96–98
House centipede, 9House flies, 4
larvae, 5life cycle, 5
House mosquitoBancroftian filariasis, 72
Howler monkeysand YF, 67
Human babesiosis, 109–111clinical and laboratory findings, 109ecology, 110medical significance, 109treatment and control, 111
Human bot fly, 212–216Human diseases transmitted
arthropods, 21Human ehrlichiosis, 96–98Human granulocytic ehrlichiosis (HGE),
96–98ecology, 99tick vectors, 99
Human immunodeficiency virus (HIV), 183–184
Human monocytic ehrlichiosis (HME), 96–98
Hump-backed flies, 212Hyalomma, 85
tick vectors, 85Hyalomma iongicornis, 85
tick vectors, 85Hydrocele, 229Hymenoptera
sting apparatus, 204Hypereosinophilia, 70
IIFA. See Indirect fluorescent antibody (IFA),
70Imaginary insect and mite infestation, 221
contributing factors, 222differential diagnosis, 223treatment strategies, 224
Immunoglobulin Mand LD, 103
Indigenous leishmaniasis, 148
244 Index
Indirect fluorescent antibody (IFA), 70African sleeping sickness diagnosis,
161babesiosis diagnosis, 110Chagas’ disease diagnosis, 157ehrlichiosis diagnosis, 99leishmanisasis diagnosis, 147microfilariae identification, 70murine typhus, 138plague diagnosis, 136RMSF diagnosis, 86scrub typhus diagnosis, 167
Infective sporozoitesmalaria, 38
Inland floodwater mosquitoes, 33Insect
characterizations, 3–4forms of development, 3–4and HIV, 183–184pathogen pick up, 19–21
Insectacharacteristics, 3–4
Insect infestationimaginary, 221
Insect mouthpartsdescription, 202illustration, 202list, 201–202
Insect pupae, activity of vs. mosquito pupae, 31
Insect stings or bites, 201–207diagnosis, 206infectious complications, 205medical significance, 201pathogenesis, 201recognition, 206
Interference phenomenon, 25Intrinsic factors
vector competence, 24Itraconazole, 159Ivermectin
lymphatic filariasis treatment, 74onchocerciasis treatment, 166
Ixodes cookie, 112Ixodes cornuatus, 121Ixodes dammini, 102Ixodes holocyclus, 14, 96, 121
geographic distribution, 122illustration, 122tick vectors, 85
Ixodes ovatus, 85tick vectors, 85
Ixodes pacificus, 104Ixodes persulcatus, 112
Ixodes ricinus, 107illustration, 108
Ixodes scapularis, 21–22, 102, 124geographic distribution, 101illustration, 101
Ixodidae, 81–83
JJapanese encephalitis (JE), 56
geographic distribution, 57Japanese spotted fever, 85Jungle YF cycles, 67
KKerititis, 229Kissing bugs, 20, 21, 153–160
beak, 158illustration, 158transmission mode, 20
Kyasanur forest disease, 111
LLaCrosse encephalitis (LAC),
46, 54geographic distribution, 56vectors, 46, 54
Larvaemosquitoes, 31
Latex agglutination (LA) tests, 138Leishmania aethiopia, 144Leishmania braziliensis, 146Leishmania chagasi, 147Leishmania donovani, 146Leishmania guyanensis, 146Leishmania infantum, 146Leishmania major, 144Leishmania mexicana, 146Leishmania panamensis, 146Leishmania tropica, 144Leishmania parasites, 143Leishmaniasis, 143–145
clinical manifestations, 143–144diagnosis, 147ecology, 148forms, 146geographic distribution, 145life cycle, 149medical significance, 143–145treatment and control, 149
Leishmanin test, 147Leptopsylla segnis, 138
Index 245
Leptotrombidium akamushiST vector species, 169
Leptotrombidium arenicolaST vector species, 169
Leptotrombidium delienseST vector species, 169
Leptotrombidium fletcheriST vector species, 169
Leptotrombidium mites, 168–169Leptotrombidium pallidum
ST vector species, 169Leptotrombidium pavlovsky
ST vector species, 169Leptotrombidium scutellaris
ST vector species, 169Leptotrombidium species, 168–169Lesions
bite, 11, 205Leukopenia, 229Lice, 5, 170–173
headlife cycle, 5
Liponyssoides sanguineus, 85Loiasis, 74, 228Lone star tick (LST), 99–100
geographic distribution, 100illustration, 99
Louping ill, 111Louse-borne diseases
treatment, control, and prevention, 174
Louse-borne infectionsmedical importance, 170
Louse-borne relapsing fever (LBRF), 174
geographic distribution, 173Louse-borne typhus, 171
geographic distribution, 173Lucilia sericata, 211, 215Lutzomyia, 21, 148–150Lutzomyia anthophora, 148Lutzomyia colombiana, 150Lutzomyia mexicana, 146Lutzomyia verrucarum, 150Lyme disease (LD), 21
clinical and laboratory findings, 103ecology, 104history, 102symptoms, 100–101tick bite, 104treatment, 105vectors, 22
Lymphadenopathy, 229Lymphangitis, 229
Lymphatic filariasisclinical and laboratory findings, 68ecology, 70–71medical significance, 68symptoms, 68treatment, 74
Lymphocytosis, 229
MMaggot infestation, 218Maggots, 209–220Malaria, 13, 35–45
causative agent, 38deaths, 13diagnosis, 38epidemiology, 35geographic distribution, 36–37history, 35incidence, 13life cycle, 39mosquitoes, 40mosquito vectors and behavior, 40symptoms, 38transmission mode, 20treatment and control, 44
Malaria organism vectorsmosquitoes, 40
Malaria plasmodiacyclopropagative transmission, 22
Malaria vaccine, 44Malaria vectors
Anopheles mosquitoes, 40Malayan filariasis, 68Mansonella ozzardi, 74Mansonella perstans, 74 Mansonella streptocerca, 74Mansonia, 72Mazzotti test, 65, 235
onchocerciasis diagnosis, 165Mechanical transmission
disease agents, 20Mectizan
lymphatic filariasis treatment, 74onchocerciasis treatment, 165
Mediterranean spotted fever, 94Mefloquine, 45Megaselia flies, 211Melarsoprol
African sleeping sickness treatment, 163Mel-B7
African sleeping sickness treatment, 163Meningoencephalitis, 48, 112, 156,
160, 227, 236
246 Index
Merozoitesmalaria, 40
Microfilaramia, 68Microfilariae identification
microscopic view, 70–71sheath showing, 70
Millipedes, 4, 9characterizations, 4,9stains on skin, 12
Mite infestationimaginary, 221
Mite islands, 166Mites
characterizations, 8Leptotromidium, 168pathogen pick up, 169trombiculid, 168
Montenegro test, 235Morulae (illustration), 97Mosquito biology, 31Mosquito-borne diseases, 35–77Mosquito-borne encephalitis, 45–56Mosquitoes, 31–77
Aedes, 32–35, 57–61, 67breathing, 33dog heartworm, 74egg laying, 34positions, 32–33
Anopheles, 32–33, 38, 40–43Bancroftian filariasis, 70breathing, 33breeding, 33dog heartworm, 74egg laying, 33positions, 33vectors, 40
Asian tigerdengue virus, 58
bird-biting, 47, 50, 53Culex, 21, 33–35, 46, 54, 56
breathing, 31, 33breeding, 33, 35dog heartworm, 74egg laying, 35positions, 32and SLE, 50and WNV, 53–54
Culicidae, 31subfamilies, 33
dark rice field, 33dengue virus mosquito markings,
60filarial worms, 74forest scrub
and YF, 67Haemagogussylvatic cycle, 67
head and mouthparts, 34HIV transmission, 183–184House, 21, 72
and Bancroftian filariasis, 72illustration, 32inland floodwater, 33larvae, 32malaria, 13, 35–45malaria organism vectors, 40Plasmodium
malaria, 38vectors, 40
Psorophora, 33–34biting patterns, 34egg laying, 33–34VEE, 55
pupae, 31–32Salt marsh, 33tree canopy YF and, 67tree hole, 21, 33–34, 67, 143
LAC, 54tularemia, 105tumblers, 31–32wigglers, 31–32yellow fever, 63–66
Mosquito houseand YF, 66
Mosquito pupae, 31activity, 31
insect pupae, 31Mosquito-transmitted encephalitis
viruses, 46–56Mosquito vectors, 21, 26, 40
dengue, 58malaria, 40and SLE, 50–51and WNV, 46, 54
Moths, 3, 16larvae, 3, 16
Mucocutaneous leishmaniasis, 143, 146geographic distribution, 145illustration, 146
Murine typhus, 136clinical and laboratory findings, 138ecology, 138medical significance, 136–137vs. Rocky Mountain spotted fever
(RMSF), 138symptoms, 138treatment, 139
Musca flies, 211
Index 247
Muscina flies, 211Myiasis, 11, 209–218
contributing factors, 215in clinical practice, 216prevention, treatment, and
control, 217Myocarditis, 230
NNeuritis, 230Neutralization, 235Nifurtimox
Chagas’ disease treatment, 159Nodules, subcutaneous, 230North Asian tick typhus, 85Norway rat, 139Nosopsyllus fasciatus, 138
OObligate myiasis, 209–218
contributing factors, 216treatment, 217–218
Obstructive filariasis, 70Ochlerotatus (formerly Aedes) mosquitoes,
31, 35Ochlerotatus sollicitans, 34, 46, 48Ochlerotatus taeniorhynchus, 48Ochlerotatus triseriatus, 33, 46
and LAC, 54Oculoglandular tularemia, 106Omsk hemorrhagic fever, 111Onchocerca volvulus, 164Onchocerciasis, 164–166
clinical and laboratory findings, 165diagnosis, 165ecology, 165medical significance, 164treatment, prevention, and control, 166vectors, 165
Opiliones, 6Orbivirus, 113Orchitis, 228Oriental rat flea, 135–137
illustration, 136Orientia tsutsugamushi, 22, 166Ornithodoros, 21, 116–117Ornithodoros erraticus
geographic distribution, 117Ornithodoros hermsi
geographic distribution, 117Ornithodoros moubata
geographic distribution, 117
Ornithodoros parkerigeographic distribution, 117
Ornithodoros porcinusgeographic distribution, 119
Ornithodoros rudisgeographic distribution, 117
Ornithodoros tholozanigeographic distribution, 119
Ornithodoros turicatageographic distribution, 117illustration, 118
Oropharyngeal tularemia, 106Oroya fever, 150Otobius megnini
illustration, 82
PPanstrongylus megistus
Chagas’ disease vectors, 159Papatasi fever, 150Paralysis, 119–123, 230Parasite transmission
modes, 20Parinaud’s oculoglandular syndrome,
140Pathogen transmission
mechanical vs. biological, 19–20
modes, 20PCR. See Polymerase chain reaction (PCR),
235Pediculus, 21, 170Pediculus humanus corporis, 170Pentavalent antimonials
leishmaniasis treatment, 149Pentostam
leishmaniasis treatment, 149Permanone, 90Permanone Repel, 90Permethrin products, 90Peromyscus leucopus, 110Peruvian warts, 150Phaenicia (Lucilia) sericata, 211Phlebotominae, 148Phlebotomus, 21, 151Phlebotomus papatasi, 151Phormia regina, 211Pian bois, 146Pimozide
imaginary insect and mite infestation treatment, 223–224
Piophilia casei, 210illustration, 210
248 Index
Plague, 133–136clinical presentation, 133diagnosis, 136ecology, 135geographic distribution, 133
state by state, 135history, 134life cycle, 135transmission mode, 135treatment, 136
Plague of Justinian, 134Plasmodium falciparum, 38, 110Plasmodium malariae, 38Plasmodium mosquitoes
malaria, 40vectors, 40
Plasmodium ovale, 38Plasmodium species, 38Plasmodium vivax, 38Pleomorphic coccobacilli, 96Pneumonic
plague form, 24Polymerase chain reaction (PCR),
235Borrelia burgdorferi detection,Chagas’ disease diagnosis, 157CSD detection, 138ehrlichiosis diagnosis, 98RMSF diagnosis, 86tularemia diagnosis, 105
Powassan encephalitis (POW), 111Promastigotes, 144, 147Propagative transmission
disease agents, 22Prophylaxis, 45Proteinuria, 230Pseudomyiasis, 209Psorophora columbiae, 33Psorophora mosquitoes
biting patterns, 35egg laying, 33and VEE, 46, 55
Psychodidae, 148Puncta, 205, 230Pupae, 3, 31
mosquitoes, 31Pyrimethamine
antimalarial drug, 45
QQueensland tick typhus (QTT), 96Quinidine
antimalarial drug, 45
Quinineantimalarial drug, 45
Quinine sulfatehuman babesiosis treatment, 111
RRabbit fever, 105Radio-immunoassay (RIA)
Chagas’ disease diagnosis, 157Rapid diagnostic tests
malaria diagnosis, 38Rash, 14, 61, 86, 92, 94, 96, 98, 105, 113, 115,
138, 165, 171, 201, 227Rats, 133, 148Rat-tailed maggot, 210
illustration, 211Rattus norvegicus, 138Rattus rattus, 23, 135, 138Red-tailed monkeys
and YF, 67Reduviidae, 153Relapsing fever, 21, 114
louse-borne vs. tick borne, 116Rhipicephalus
tick vectors, 85, 87, 94Rhipicephalus appendiculatus, 94Rhipicephalus sanguineus, 85, 87Rhodnius, 159Rhodnius prolixus
Chagas’ disease vectors, 159Rice culture, 27Rice rats, 138Rickettsia africae, 85Rickettsia akari,22, 85Rickettsia australis, 85Rickettsiaceae, 84Rickettsia conori, 85Rickettsiae, 84Rickettsia honei, 85Rickettsia japonica, 85Rickettsial disease, 21–22, 84Rickettsial pox, 22Rickettsia montana, 25Rickettsia parkeri, 85Rickettsia peacocki, 25Rickettsia prowazekii, 21Rickettsia rhipicepahali, 25Rickettsia rickettsii, 22, 25, 85Rickettsia siberica, 85Rickettsia typhi, 138
murine typhus, 138Rifampin
CSD treatment, 141
Index 249
Riparian habitat, 26–27River blindness, 164Rochalimaea henselae, 140Rochalimaea quintana, 171Rocky Mountain spotted fever
(RMSF), 84characteristics, 84clinical and laboratory aspects, 85ecology, 87infected tick bite, 87prevention, 87symptoms, 84
Rocky Mountain wood tick, 87–88Romana’s sign, 156Roof rat, 139Russian spring-summer encephalitis (RSSE),
111–112
SSarcophaga flies, 211
illustration, 213Salivary excretions
arthropods, 11, 153, 205, 208Salt marsh mosquitoes, 33, 34, 48Salt marsh mosquitoes
biting patterns, 35epizootic vector species, 48
Sand flies, 10, 142, 148, 150biology, 148
Sand fly fever, 150Sand fly-transmitted diseases, 150Sarcophaga flies, 211Sarcophaga haemorrhoidalis, 213Scorpion
stinging position, 8venom, 11
Scorpions, 3, 4, 8, 13characterizations, 4, 9
Screwworm flies, 11, 212, 214, 216, 218illustration, 214
Scrub typhus, 166–169clinical and laboratory findings, 167diagnosis, 167ecology, 168geographic distribution, 167medical significance, 166treatment, prevention, and control, 168vectors, 169
Sensu latu, 26Septicemic plague, 133Shock, 62, 231Siberian tick typhus (STT), 84–85Simulium, 21, 164–165
Simulium damnosum, 165Simulium flies, 21, 165Simulium metallicum, 166Simulium neavei, 165Simulium ochraceum, 166Skin biopsies
onchocerciasis diagnosis, 165Sleeping sickness, 160–164Social insects, 11Soft ticks, 81, 83, 116
characteristics, 81illustration, 82
Soldier fly, 209, 210, 216illustration, 210
Spider monkeys, YF and, 67Spiders, 3–7, 11, 187–192
bites, 187black widow
venom, 11brown widow
venom, 11characterizations, 4–5daddy longlegs, 6fiddle back
venom, 187venom, 11, 187
Splenomegaly, 146Sporozoites (malaria), 40Spotted fever group, 25, 84–85
epidemiologic information, 84–85Spotted fever rickettsioses, 84St. Louis encephalitis, 46, 49–52
control, 52ecology, 50–51geographic distribution, 51life cycle, 50symptoms, 50vectors, 50–51
Sting apparatus, 204Stings, 10, 11, 14, 195–198
arthropods, 11Streptomycin
plague treatment, 136tularemia treatment, 108
Sulfonamidesantimalarial drug, 45
SuraminAfrican sleeping sickness treatment,
163onchocerciasis treatment, 164
Sylvatic plague, 133Sylvatic YF, 67Symbiotic rickettsial organism, 122Systemic tick-borne illness, 100
250 Index
TTachycardia, 231Tapeworm
transmission mode, 20Tarantula, 7Tests
arthropod-borne diseases, 233Tetracycline
antimalarial drug, 45ehrlichiosis treatment, 100louse-borne disease treatment, 174murine typhus treatment, 139plague treatment,136RMSF treatment, 86TBRF treatment, 117tularemia treatment, 108
Theileria, 110Three-day fever, 150Tick-borne encephalitis, 111–113
diagnosis and treatment, 113Tick-borne relapsing fever (TBRF), 114
clinical and laboratory findings, 114diagnosis, 115ecology, 116geographic distribution, 118vs. louse-borne, 116medical significance, 119symptoms, 114–115treatment and control, 117
Tick paralysis, 119clinical features, 119–120mechanisms, 121medical significance, 119prevention and treatment, 123
Tick removalmethod, 91
TicksAmerican dog, 21, 22, 87, 99, 107, 121biology, 81bite, 86–87, 90, 94, 96
eschar, 94–95Lyme disease, 102Rocky Mountain Spotted Fever
(RMSF), 87characterizations, 8deer, 102
geographic distribution, 101illustration, 101
Dermacentor, 22, 25, 85, 87, 96, 99, 123Gulf coast
diseases associated with, 92–93dog, 21, 22, 87, 99, 107hard, 81
characteristics, 81
illustration, 82interference phenomenon, 25Ixodes, 85, 96, 99, 102, 104, 107, 112, 121
illustration, 101life cycle, 83lone star tick (LST), 21, 93, 99
geographic distribution, 100illustration, 99
removal, 91Rocky Mountain wood tick, 87–88soft, 81, 83, 116
characteristics, 81illustration, 82
tularemia, 107western black-legged, 110
Timorian filariasis, 68TMP-SMX
CSD treatment, 141Toxorhynchitinae, 31
characteristics, 31Transmission of pathogens
mechanical vs. biological, 19–20Tree canopy mosquitoes
and YF, 67Tree hole mosquitoes, 33, 46
and LAC, 46, 54Trench fever, 171Triatoma brasiliensis
Chagas’ disease vectors, 159Triatoma bugs, 157Triatoma dimidiata
Chagas’ disease vectors, 159Triatoma infestans
Chagas’ disease vectors, 159Triatoma protracta
Chagas’ disease vectors, 154allergy to bites, 154
Triatoma sanguisugaChagas’ disease vectors, 154
Triatominae, 153Trombiculid mites, 168True bugs, 153Trypanosoma brucei gambiense, 160Trypanosoma brucei rhodesiensei, 160Trypanosoma cruzi, 158–159Trypanosoma rangeli, 157Trypomastigote, 157Tsetse flies, 21, 160
illustration, 166Tularemia, 105
arthropod transmission, 107clinical and laboratory findings, 106medical significance, 105treatment, 108
Index 251
Tumblersmosquitoes, 31
Typhus island, 166
UUlceroglandular, 106Ulcers, cutaneous, 122Urban YF cycles, 67Urine tests
onchocerciasis diagnosis, 165Urticaria, 14–15, 201, 206, 230Uta, 10
VVector-borne diseases, 10, 12, 13, 24, 153Vector competence, 24Vector mosquitoes
sylvatic cycleHaemagogus mosquitoes, 67
VectorsAfrican sleeping sickness, 161–162Anopheles mosquitoes, 40Chagas’ disease, 157competent, 24incrimination, 25onchocerciasis, 164Plasmodium mosquitoes, 40scrub typhus, 168
Venezuelan equine encephalitis, 46, 55Vectors, 55
Venom, 11, 205black widow spider, 11brown widow spider, 11fiddle back spider, 205fire ants, 11, 196scorpion, 11spiders, 11, 205
Verruga peruana, 150Viral encephalitis, 56, 111Viruses
tick transmission, 111Visceral leishmaniasis, 144–146
geographic distribution, 145
WWayson stain, 136
Wasps, 3, 11, 13, 14, 202sting apparatus, 204stings, 203–205
Weil-Felix reactions, 86West Nile virus, 46
life cycle, 53control, 54vectors, 46
Western black-legged tick, 104Western equine encephalitis, 46
geographic distribution, 55vectors, 46
White-footed mouse, 110Wigglers
mosquitoes, 31Wild rats, 138Winterbottom’s sign, 161Wood rats, 138, 148Wright’s stain
plague diagnosis, 136Wuchereria bancrofti, 70
Bancroftian filariasis, 70–72life cycle, 73lymphatic filariasis treatment, 74
XXenopsylla, 135–138Xenopsylla cheopis, 135, 137–138
illustration, 136
YYellow fever mosquitoes, 65Yellow fever (YF), 63–68
geographic distribution, 64history, 65–66jungle vs. urban, 67medical significance, 63treatment and prevention, 67
Yellowjacketsting apparatus, 204
illustration, 204Yersinia pestis, 133
ZZoonoses
encephalitis, 45
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